P07-13 Barriers and opportunities to improve collaboration between healthcare and physical activity professionals involved in prescribing physical activity for inactive people in the Netherlands

Abstract Background Healthcare professionals play an important role in motivating inactive people with a chronic disease (e.g. diabetes, cancer, heart disease) for physical activity. They can initiate a discussion about physical activity with the patient and refer to a physical activity (PA)-professional for more detailed action-planning through ‘physical activity on prescription'. However, the collaboration between healthcare and PA-professionals to refer and guide patients to physical activities is in its infancy and can be improved. To enhance this collaboration the aim of our study was to evaluate how the collaboration is shaped and what barriers were experienced. Methods We conducted an exploratory study in which quantitative and qualitative research methods were used. Two online questionnaires were distributed among PA-professionals in the Netherlands (spring and autumn 2021). Questionnaires were returned by respectively 209 and 116 respondents. Questions on how the collaboration was shaped, how the collaboration worked and what barriers were experienced were asked. Besides that, two focus group discussions were held with PA-professionals (n = 8) focussing on barriers and opportunities to improve ‘Physical activity prescription'. Results More than half of the Dutch PA-professionals indicate that they collaborate with healthcare professionals in primary care (56%) to guide patients to physical activities. Far fewer PA-professionals collaborate with healthcare professionals in secondary care (22%). Half of the respondents indicate that they experience the collaboration in physical activity prescription as insufficient (47%). Most important barriers are determined, for example healthcare and PA-professionals are unfamiliar with each other; there is uncertainty about roles and tasks of professionals involved; there is a lack of communication; PA-professionals sometimes do not have the skills to guide people with a chronic disease. Finally, a lack of time and budget limits the collaboration between professionals involved in physical activity on prescription. Conclusions The collaboration between professionals to refer and guide inactive people with a chronic disease from the healthcare setting to physical activities can be improved by responding to the barriers that are indicated by this study. This study contributes to improving health-enhancing physical activity in an inactive target group and decreasing the prevalence of physical inactivity.


Background
Healthcare professionals play an important role in motivating inactive people with a chronic disease (e.g. diabetes, cancer, heart disease) for physical activity. They can initiate a discussion about physical activity with the patient and refer to a physical activity (PA)-professional for more detailed action-planning through 'physical activity on prescription'. However, the collaboration between healthcare and PAprofessionals to refer and guide patients to physical activities is in its infancy and can be improved. To enhance this collaboration the aim of our study was to evaluate how the collaboration is shaped and what barriers were experienced.

Methods
We conducted an exploratory study in which quantitative and qualitative research methods were used. Two online questionnaires were distributed among PA-professionals in the Netherlands (spring and autumn 2021). Questionnaires were returned by respectively 209 and 116 respondents. Questions on how the collaboration was shaped, how the collaboration worked and what barriers were experienced were asked. Besides that, two focus group discussions were held with PA-professionals (n = 8) focussing on barriers and opportunities to improve 'Physical activity prescription'.

Results
More than half of the Dutch PA-professionals indicate that they collaborate with healthcare professionals in primary care (56%) to guide patients to physical activities. Far fewer PAprofessionals collaborate with healthcare professionals in secondary care (22%). Half of the respondents indicate that they experience the collaboration in physical activity prescription as insufficient (47%). Most important barriers are determined, for example healthcare and PA-professionals are unfamiliar with each other; there is uncertainty about roles and tasks of professionals involved; there is a lack of communication; PA-professionals sometimes do not have the skills to guide people with a chronic disease. Finally, a lack of time and budget limits the collaboration between professionals involved in physical activity on prescription.

Conclusions
The collaboration between professionals to refer and guide inactive people with a chronic disease from the healthcare setting to physical activities can be improved by responding to the barriers that are indicated by this study. This study contributes to improving health-enhancing physical activity in an inactive target group and decreasing the prevalence of physical inactivity. Keywords: Healthcare, Referral, Inactive, Physical activity, Professionals

Physical and social environmental determinants of physical activity
Background Evidence suggest that greenspace use can be associated with children's physical, mental, social health, and well-being (Tillmann et al., 2018;Mygind et al., 2019;Mygind et al., 2021). Greenspace can facilitate a wide range of low-cost activities and the availability of greenspace is frequently linked to increased levels of recreational physical activity. Accordingly, contemporary children's declining greenspace use prompts a need to understand the factors that affect frequency of use.

Methods
Aiming to determine to what extent demographic, environmental and social factors predict greenspace use for schoolaged (6-15-year-old) children in Denmark, a national online survey was distributed to parents of 10.000 0-15-year-old children. From a total of 4772 responses a sub-sample of 3171 responses from parents of school-aged children was included in the analysis for this study. The aim was addressed by answering the following research questions: 1) How often do Danish children use greenspaces? 2) What demographic differences in greenspace use are present? 3) How do social and environmental factors predict greenspace use? Results Responses from the 3171 parents showed that 49.5% of the children used greenspace almost every day during the summer season. Multivariate binary logistic regression analysis showed that the number of types of greenspaces within walking or cycling distance from home was a strong predictor for daily use. Social factors (parental concern and encouragement) also predicted use, but less so. Geography and child age were the only demographic predictors for using greenspace almost every day.

Conclusions
Findings from the present study suggest that providing opportunity for choosing between various types of greenspaces within walking or cycling distance might be an effective way to